Medicinal Cannabis: the debate continues

13 July 2018. Published by Emma Kislingbury, Senior Associate

With the debate over medicinal cannabis still going strong, we update you on recent developments which have dominated the headlines.

In a blog earlier this year we touched upon the case of Alfie Dingley, aged 6, whose request for a licence to allow him legally to take cannabis oil to treat his epilepsy had been rejected by the Government.


Now, following a fierce public response, that decision has, temporarily at least, been overturned.


Last month, Home Secretary Sajid Javid gave special dispensation for Alfie to use the drug to prevent life threatening seizures. This followed the Government's decision to grant a 20-day licence to 12-year old Billy Caldwell, who hit the headlines after cannabis oil from Canada, used to treat his severe epilepsy, was confiscated from his mother at Heathrow airport.


These decisions accompanied a Government announcement that it would be establishing an expert panel of clinicians to advise ministers on individual applications to prescribe cannabis-based medicines. The applications process will be quick, with ministers issuing final decisions within 2 to 4 weeks.


The panel is intended as an interim measure whilst the Government undertakes a two-part review into the classification of cannabis for medicinal purposes. Cannabis based products are currently listed in Schedule 1 of the Misuse of Drugs Regulations 2001 (Schedule 1 drugs by definition have little or no therapeutic benefits). If the review identifies significant medical and therapeutic benefits, the intention is for cannabis to be re-classified for medical use.


The first part of the review is now complete and England's Chief Medical Officer, Dame Sally Davies, has reported that there is "clear evidence from highly respected and trusted research institutions that some cannabis based medicinal products have therapeutic benefits for some medical conditions".


In light of these findings, Dame Sally Davies questions, in her report the rationale for keeping cannabis based medicinal products within Schedule 1. Moving these drugs out of Schedule 1 would mean that registered practitioners could, under controlled conditions, prescribe them for medical benefit. It would also allow further research to be undertaken, including by means of clinical trials, to improve the evidence base for the therapeutic benefits associated with using cannabis-based drugs.


The Government review is a significant step towards changing the current laws around medical cannabis, and investors have been quick to catch on to the opportunities this might bring – Imperial Brands, better known for its position in the tobacco industry, has reportedly invested in Oxford Cannabinoid Technologies (OCT), a UK-based biopharmaceutical company researching cannabinoid-based medicine. Chief Development Officer of Imperial Ventures, Matthew Phillips, has stated that the investment "enables Imperial to support OCT’s important research while building a deeper understanding of the medical cannabis market".


Public response to the Government's review has been largely positive. A number of medical experts have welcomed Dame Sally Davies' findings and the potential opportunities that reclassification may bring in terms of improved patient treatment. Dr Adrian James, a registrar at the Royal College of Psychiatrists has acknowledged the "significant health benefits" that properly reviewed and approved cannabis products for medicinal use can have.


The legalisation of cannabis for recreational purposes remains a far more divisive issue both for the public and the medical profession; Dr James said: "as mental health doctors we can say with absolute certainty that its use carries severe risks for some, including psychosis, depression and anxiety”. The Government has made it clear that the current review will not consider reclassification of cannabis as a Class B drug and will not consider the legalisation of cannabis for recreational use.


The second part of the Government's review has now been commissioned; the Advisory Council on the Misuse of Drugs is expected to advise on whether cannabis-related medicinal products should be rescheduled within the next few weeks. Pharmaceutical companies, medical practitioners and families like Alfie Dingley's and Billy Caldwell's, for whom the review has personal significance, will no doubt be eagerly awaiting the outcome.

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